Elsevier

The Journal of Arthroplasty

Volume 25, Issue 8, December 2010, Pages 1240-1245
The Journal of Arthroplasty

Temporary Drainage Clamping After Total Knee Arthroplasty: A Meta-Analysis of Randomized Controlled Trials

https://doi.org/10.1016/j.arth.2009.08.013Get rights and content

Abstract

Drainage-clamping methods are thought to be effective in reducing blood loss after total knee arthroplasty (TKA). We conducted a systematic review to examine if these methods were effective without increasing the risk of complications. After a comprehensive search, 6 randomized controlled trials involving 603 knees and comparing clamping drainage and the immediate release of the drain after elective TKA were included in this analysis. The results demonstrated that drainage clamping could decrease the volume of drainage, but only clamping for no less than 4 hours could reduce the true blood loss. There was no significant difference between the 2 groups regarding blood transfusion, postoperative range of motion, incidence of thromboembolic events, and wound complications. The current evidence cannot confirm the advantage of clamping drainage after TKA.

Section snippets

Materials and Methods

We followed the methodological guidelines outlined by the Cochrane Collaboration (Oxford, UK) [28] to conduct this meta-analysis. The findings were reported according to the recommendations outlined in the Quality of Reporting of Meta-Analyses statement [29].

Identified Trials

A total of 1653 articles were retrieved in the search. Ten randomized controlled trials comparing various clamping methods and conventional drainage were identified. Two studies dealing with a comparison between different clamping methods were excluded. Another 2 studies were excluded because of missing data or a poor quality of methodology 16, 19. The remaining 6 studies were included in the meta-analysis (Table 1). The authors of 2 articles 18, 21 provided additional data after contact. These

Discussion

The use of closed suction drains in TKA is a common practice, although it has been questioned, and the effect of clamping the drain tube is also not clear. Several reports with varying results regarding the delayed release of the drain have been published in the last decade. Therefore, we conducted a systematic review of the literature and subsequent meta-analysis of the results. Our present study could not provide enough evidence to support the application of temporary clamping of the drain

Acknowledgment

The authors would like to thank Miss Windy Chia-Jung Ho for the excellent assistance.

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    No benefits or funds were received in support of the study.

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